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结直肠癌致急性肠梗阻的治疗体会目的：分析结直肠癌致急性肠梗阻的治疗效果。
方法：选择医院2011年2月～2014年6月收治的结直肠癌致急性肠梗阻患者64例，根据治疗方案不同分为两组，每组32例，对照组实施传统手术治疗，观察组实施肛肠梗阻导管联合手术治疗，对两组患者的临床治疗效果进行分析与比较。
结果：观察组患者梗阻缓解率、肠道清洁效果明显优于对照组，且观察组术后感染发生率低于对照组，组间比较差异均具有统计学意义（P＜0.05）。
结论：结直肠癌合并急性肠梗阻患者在外科治疗前先实施肛肠梗阻导管治疗，可有效缓解肠梗阻，提高Ⅰ期手术率，值得临床推广。
标签：结直肠癌；急性肠梗阻；治疗；效果Objective：to analyse the therapeutic effect of colorectal cancer complicating acute intestinal obstruction. Methods：choose hospital from February 2011 to June 2014，64 patients with colorectal cancer complicating acute intestinal obstruction，according to different operation scheme is divided into two groups，32 cases in each group，control group implementation of traditional surgery，observation group implementation of anus bowel obstruction catheter combined surgical treatment，the clinical therapeutic effect of two groups of patients were analyzed and compared. Results：the observation group of patients with obstruction remission rate，intestinal cleaning effect was better than control group，observation group of postoperative infection rate is lower than the control group，comparing differences between groups were statistically significant （P 0.05），具有可比性。
①便血原因：便血不是一种疾病，准确一点来说，只是各个系统疾病所导致的症状，临床上较为常见。
血液从肛门排出，大便带血，或全为血便，颜色呈鲜红、暗红或柏油样，均称为便血。
1.炎症、溃疡性因素如下消化道的黏膜发生炎症或溃疡时，因黏膜充血、水肿与溃疡形成，当炎症或溃疡侵蚀血管或血管通透性增加、小血管破裂均可发生便血。
2.血管性因素出血系下消化道各种血管性病变，导致血管破裂或导致肠系膜血管缺血、肠黏膜的血供障碍所致。
3.机械性因素:如肠套叠或肠扭转，肠扭转时间过长时，可因肠管的血运障碍而致出血。
4.肿瘤性因素下消化道的良、恶性肿瘤较多，是引起出血的重要病因之一。
5.全身性疾病：传染病如伤寒、副伤寒，血液病如血友病、腹型过敏性紫癜(Henoch型紫癜。
一般而言，幼儿、青少年便血以结肠息肉、肠套叠、美克耳憩室及炎症性疾病为常见病因;中、老年患者则以肠道炎症性病变、结肠、直肠癌、肠道血管性病变为多见病因;肛周病变如痔核、肛裂或瘘管在成人亦不应忽视。
上消化道出血：是指屈氏韧带以上的消化道，包括食管、胃、十二直肠或胰胆等病变引起的出血，胃空肠吻合术后的空肠病变出血亦属这一范围。
大量出血是指在树小时内失血量超出1000ML或循环血容量的20%，其临床主要表现为呕血和（或）黑粪。
上消化道出血常见疾病有：胃炎、胃及十二指肠溃疡、肝硬变、食管及胃肿瘤等。
下消化道出血：下消化道出血通常包括肛管直肠疾病引起的出血。
肛肠疾病成为下消化道出血的主要原因。
下消化道出血常见疾病有：肛裂、痔疮、肛瘘、慢性结肠炎、结肠或直肠息肉、肿瘤等。
便血的原因几乎全消化道出血均可引起便血，但常见的便血的原因有：(1)便血的原因之肛门疾病：①血色鲜红无疼痛者，多见于内痔，Ⅰ期痔核以便血为特征，常因大便擦破痔核而出血，所下之血，或点滴不已，或可射血，或仅在手纸上带血；Ⅱ期痔核便血不多或不出血，常脱出肛门之外。
②肛裂的便血多伴有肛门疼痛及典型的便后周期性疼痛。
结直肠癌合并急性肠梗阻的手术治疗效果发布时间：2022-06-23T07:11:14.188Z 来源：《中国医学人文》2022年8期作者：付兆林[导读] 分析结直肠癌合并急性肠梗阻的手术治疗效果付兆林绥化市人民医院 152000【摘要】目的分析结直肠癌合并急性肠梗阻的手术治疗效果。
方法选取本院2020年3月-11月期间收治的50例结直肠癌合并急性肠梗阻患者进行研究，行一期切除吻合术（结肠病变部位）36例；行分期手术（切除肿瘤部分、近端结肠外置造口、封闭远端、择期吻合肠端）6例；行一期造瘘术3例；行二期肿瘤切除及肠吻合术3例；行单纯造瘘术2例。
结果 50例中有48例经手术治疗后肠梗阻症状大幅度改善，术后1例切口感染、1例吻合口瘘，经对症处理后均痊愈。
术后１例感染肺部，抗感染处理后愈合。
１例由于多器官功能衰竭死亡。
平均住院时间（22.36±5.43）d。
结论临床中针对结直肠癌合并肠梗阻患者尽早诊断和实施手术，结合患者的病情选择恰当的手术方式，从而对治疗效果有效提升，如果患者符合一期肠切除吻合术的适应症，尽量使用一期肠切除吻合术，这样患者的生存率更高。
【关键词】结直肠癌；急性肠梗阻；手术治疗；[Abstract] Objective To analyze the effect of surgical treatment of colorectal cancer complicated with acute intestinal obstruction. Methods 50 patients with colorectal cancer complicated with acute intestinal obstruction treated in our hospital from March to November 2020 were studied. 36 patients underwent one-stage resection and anastomosis (colon lesion site); 6 cases underwent staged surgery (resection of tumor part, external colostomy at the proximal colon, closure of distal end and selective anastomosis of intestinal end); Three cases underwent one-stage fistula; Secondary tumor resection and intestinal anastomosis were performed in 3 cases; Simple fistula was performed in 2 cases. Results among the 50 cases, 48 cases of intestinal obstruction were significantly improved after surgical treatment. One case of incision infection and one case of anastomotic fistula were cured after symptomatic treatment. One case had pulmonary infection and healed after anti infection treatment. One case died of multiple organ failure. The average hospital stay was (22.36 ± 5.43) days. Conclusion in clinical practice, patients with colorectal cancer complicated with intestinal obstruction should be diagnosed and operated as soon as possible, and the appropriate operation mode should be selected according to the patient's condition, so as to effectively improve the treatment effect. If the patients meet the indications of one-stage intestinal resection and anastomosis, one-stage intestinal resection and anastomosis should be used as far as possible, so that the survival rate of patients is higher.【 key words 】 colorectal cancer; Acute intestinal obstruction; Surgical treatment;临床中外科常见的一种急腹症是结直肠癌并急性肠梗阻，出现肠梗阻症状后会导致肠管近端出现膨胀、压力升高问题，导致肠黏膜出现缺血、缺氧症状，肠管壁不能正常的进行血运，导致肠出现坏死、穿孔等严重问题，最终导致患者出现严重并发症（感染腹腔、休克等）【1】。
